Psychological Testing - APA Services

1 Page 1 of 3 Copyright 2018 by the American Psychological Association and the APA Practice OrganizationCurrent Procedural Terminology (CPT) copyright 2018 American Medical Association. All Rights of the CPT manual can be ordered from the AMA or by calling (800) TestingCrosswalk for 2019 Psychological Testing and evaluation CPT CodesCPT Codes and Descriptors Effective January 1, 2019 Professional and Technical Activities Performed by the Psychologist Please note that the new codes do not cross-walk on a one-to-one basis with the deleted codes. The single code, 96101, will now be billed using up to four (4) codes; two (2) codes for Psychological evaluation Services (96130, 96131) and two (2) for Test Administration and Scoring (96136, 96137).

2 evaluation Services include interpretation of test results and clinical data, integration of patient data, clinical decision making, treatment planning, report generation, and interactive feedback to the patient, family member(s) or caregiver(s). -The first hour of Psychological evaluation is billed using 96130 and each additional hour needed to complete the service is billed with the add-on code 96131. -CPT Time Rules allow an additional unit of a time-based code to be reported as long as the mid-point of the stated amount of time is passed. Beyond the first hour (96130), at least an additional 31 minutes of work must be performed to bill the first unit of the add-on code 96131.

3 evaluation Services must always be performed by the professional prior to test administration, and may be billed on the same or different days. Test administration and scoring Services performed by the psychologist includes time spent to administer and score a minimum of two (2) Psychological tests. -The first 30 minutes of test administration and scoring is billed using 96136 and each additional 30-minute increment needed to complete the service is billed with code 96137. -CPT time rules apply to the add-on code if, beyond the first 30 minutes, at least an additional 16 minutes of work is Testing BY PSYCHOLOGIST OR PHYSICIANPSYCHOLOGICAL Testing evaluation Services BY PROFESSIONAL 2018 CPT Code2018 CPT Descriptor2019 CPT Code2019 CPT Descriptor96101 Psychological Testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, , MMPI, Rorschach, WAIS)

4 , per hour of the psychologist s or physician s time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report96130* Psychological Testing evaluation Services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour96131*Each additional hour (List separately in addi-tion to code for primary procedure)TEST ADMINISTRATION AND SCORING BY PROFESSIONAL 96136** Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method, first 30 minutes96137**Each additional 30 minutes (List separately in addition to code for primary procedure) * Professional Services , such as test selection, clinical decision-making and test interpretation, previously billed with 96101, should now be billed using Psychological evaluation codes (96130 and 96131).

5 **Time spent scoring tests is now considered to be billable 2 of 3 Copyright 2018 by the American Psychological Association and the APA Practice OrganizationCurrent Procedural Terminology (CPT) copyright 2018 American Medical Association. All Rights of the CPT manual can be ordered from the AMA or by calling (800) TestingCrosswalk for 2019 Psychological Testing and evaluation CPT CodesCPT Codes and Descriptors Effective January 1, 2019 Professional Services Performed by the Psychologist and Technical Services Performed by Technician Please note that the new codes do not cross-walk on a one-to-one basis with the deleted codes. The single code, 96102, will now be billed using four (4) codes; two (2) codes for Psychological evaluation Services (96130, 96131) and two (2) for Test Administration and Scoring by Technician (96138, 96139).

6 Psychological evaluation Services include interpretation of test results and clinical data, integration of patient data, clinical decision making, treatment planning, report generation, and interactive feedback to the patient, family member(s) or caregiver(s). -The first hour of evaluation is billed using 96130 and each additional hour needed to complete the service is billed with code add-on 96131. -CPT Time Rules allow an additional unit of a time-based code to be reported as long as the mid-point of the stated amount of time is passed. Beyond the first hour (96130), at least an additional 31 minutes of work must be performed to bill the first unit of the add-on code 96131.

7 evaluation Services must always be performed by the professional prior to test administration, and may be billed on the same or different days. Test administration and scoring Services performed by the Technician includes time spent to administer and score a minimum of two (2) Psychological tests. -The first 30 minutes of test administration and scoring is billed using 96138 and each additional 30-minute increment needed to complete the service is billed with code 96139. -CPT time rules apply to the add-on code if, beyond the first 30 minutes, at least an additional 16 minutes of work is ADMINISTEREDPSYCHOLOGICAL TESTINGPSYCHOLOGICAL Testing evaluation Services BY PROFESSIONAL2018 CPT Code2018 CPT Descriptor2019 CPT Code2019 CPT Descriptor96102 Psychological Testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, , MMPI and WAIS)

8 , with qualified health care professional interpretation and report, administered by technician, per hour of technician time, face-to-face96130* Psychological Testing evaluation Services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour96131*Each additional hour (List separately in addition to code for primary procedure)TEST ADMINISTRATION AND SCORING BY TECHNICIAN 96138** Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes96139**Each additional 30 minutes (List separately in addition to code for primary procedure)* Professional Services , such as test selection, clinical decision-making and test interpretation, previously billed with 96102, should now be billed using Psychological evaluation codes (96130 & 96131).

9 **Time spent scoring tests is now considered to be billable 3 of 3 Copyright 2018 by the American Psychological Association and the APA Practice OrganizationCurrent Procedural Terminology (CPT) copyright 2018 American Medical Association. All Rights of the CPT manual can be ordered from the AMA or by calling (800) TestingCrosswalk for 2019 Psychological Testing and evaluation CPT CodesCPT Codes and Descriptors Effective January 1, 2019 Psychiatric diagnostic evaluationPlease note that no changes have been made to CPT code 90791. This service includes a comprehensive diagnostic evaluation of Psychological and psychosocial conditions and is performed prior to Psychological evaluation and test administration and scoring DIAGNOSTIC EVALUATION2018 CPT Code2018 CPT Descriptor2019 CPT Code2019 CPT Descriptor90791 Psychiatric diagnostic evaluation90791 Psychiatric diagnostic evaluation *No Change for 2019